Starting T3

[Jacarilla]

Today I saw an nhs endo who agreed to prescribe a 3 month trial of T3 (liothyroxine) From previous post and advice on here I believe I am a poor converter. He wasn’t entirely sympathetic and disagreed with most things I said. His views included ‘no point in testing T4 or T3 as it’s too variable, only test TSH.’ T3 works for some but it may just be placebo.’ ‘You should take your levo on the morning of your blood test’ etc etc… I smiled sweetly as all that mattered was his willingness to prescribe.

I am currently on 100mg levo and quite sensitive to changes. He’s prescribed 20mg T3 and reduce to 50mg levo all taken in one dose in the morning. He said see how I go and if in a couple of weeks I’m experiencing adverse effects to discontinue and go back to my existing regime. I’m a little nervous to embark on the change but know I must try it to see if it works for me. My main symptom is exhaustion.

As an aside he’s given me a new brand of levo as my current brand is not available in the Uk. I moved back from Spain last year and brought a stock of Eutirox with me. He’s given me mercury pharma generic levo.

i have 3 questions :

I still have my eutirox brand of levo and could use these so that I’m not making two changes?

Does his prescribed regime sound sensible?

will I, as he suggested, know if there’s a benefit within a week or two?

Thanks in advance you lovely people

[joey82]

I get on well with Mercury pharma, so I wouldn't worry about that so much. But people react differently to different brands so it may not work for you.

You are right to only make one change at a time! So please don't take your t3 and MP all at once. Make slow, methodical changes.

To cut your Levo by 50mcg and then start taking 20 mcg all in one go would disastrous. Please don't make a sudden change like that. Your endo is a complete twat to suggest that.

Your prescription for t3 is a good start, but it needs to be administered carefully. Introducing your t3 gradually and decreasing your t4 gradually as well.

I really would suggest reading some of Paul Robinsons books or taking some advice from here before your proceed.

Can you cut your t3 into 5mcg or even 2.5mcg using a pill cutter? You undoubtedly needs to take at least 2 separate doses or t3 a day, at the same time.

I really would suggest your do some research before proceeding. This is a good opportunity and you don't want to prove your idiot endo right!

[Jacarilla in reply to joey82]

Omg I’m so glad I consulted this forum !

[greygoose]

He's setting you up to fail! That much is obvious. He's reduced your levo by too much - possibly wasn't even necessary to reduce it at all because taking T3 will reduce FT4 levels. And starting on 20 mcg all in one go is sheer lunacy. It's far too much and will be a terrible shock to the system. Which is why, IMHO, he's said to stop it if you feel worse in about two weeks time. If you do it your way, you probably will feel worse in two weeks time!

If I were you, I would reduce levo by 25 mcg - if you can manage that - for a few days before starting on just 5 mcg T3. You can take them both together to start with. Stay on that for about two weeks and if all goes well, increase by 5 mcg - either at the same time or later in the day. And, continue like that until you reach the 20 mcg he's prescribed. Don't bother to say anything to him about about how you're doing it. Knowing that you haven't followed his dastardly plan might make him aggressive! lol

[Jacarilla in reply to greygoose]

The ignorance in the medical profession is truly scary!

[greygoose in reply to Jacarilla]

I don't think this was ignorance. I think he did it deliberately because he doesn't want to prescribe T3.

[Jacarilla in reply to greygoose]

Oh that’s an interesting thought … it hadn’t occurred to me.

[Dawney63 in reply to greygoose]

I'm new to all this so I googled T3 medication as I wasn't sure what it was and it came up with this.

[greygoose in reply to Dawney63]

??? You haven't told us what 'this' is.

T3 is not a medication in the normal sense of the word. It is the active thyroid hormone.

T4 (levo) is basically a storage hormone that doesn't do much until it is converted into T3. But, not all of us a good at that conversion process, so we need to take T3 with a reduced dose of levo.

[SlowDragon Ambassador]

June 23

results on 88mg 2 times a week and 100mg (88+12.5) 5 times a week

T4 free serum. 19.3 pmol/L (12.0-22.0) 73%

T3. Free serum 3.4 pmol/L (3.10-6.80) 8.11%

TSH. 0.6 miu/L (0.7-4.2) -2.86

Are these your most recent thyroid results

Or is there any newer Ft4 and Ft3 results

[Jacarilla in reply to SlowDragon]

these are latest results but since June I increased to 100mg daily… I’m having a blood test tomorrow so will see results in about a week.

[SlowDragon Ambassador]

assuming similar results

Initially reduce levothyroxine by 25mcg…..wait 4-5 days before starting on just 5mcg T3 waking……

or possibly 2.5mcg waking (if you can cut tablets that small)

If 2.5mcg waking….add 2nd 2.5mcg late afternoon

After about a week add further 5mcg …..so taking 5mcg waking and 5mcg mid/late afternoon

See how that is

Don’t be in a rush to increase further

Retest after 6 weeks

[Jacarilla in reply to SlowDragon]

Am I correct in thinking the split dose of T3 is to do with tolerating it (as in it not causing an issue) or is it because it’s short life ones system? And if split dose is necessary is it as fussy as levo with regards to an empty stomach with nothing else taken around the same time?

[helvella Administrator in reply to Jacarilla]

Somewhere in the middle.

It has a short half-life. (Depending on where you look, around about 24 hours.) Hence taking once a day can see a rapid rise in levels, followed by a fairly fast reduction. That is, it can be very "peaky".

And if that peak takes you as an individual to a level which causes symptoms of excess (albeit only for a short period), then splitting can help.

However, others find they do best one one dose a day.

(And even if it has a short half-life as T3 in the blood stream, its effects continue for much longer - typically people suggest a couple of days.)

[DippyDame]

His protocol won't work....then he can say, you had T3, it didn't work, so no point in prescribing.

Just noticed excellent replies from greygoose and SlowDragon....follow their advice! They gave me some very sound advice when I started T3....and since then.

I need high dose T3-only to function and can assure you that a 3 month trial of T3 is but a few steps along a very long, bumpy road.

The man appears to be an idiot or devious or both....he certainly won't improve your wellbeing.

So, use him to get the T3, ignore his advice ( your gut instinct is already ringing alarm bells!) and follow the "low and slow" advice on offer

Just adding my two penny worth!!

[Jacarilla in reply to DippyDame]

Thanks so much! It is with trepidation that I embark on this journey so the advice I get here is both invaluable and comforting, to know I have the support of those that have trodden the path before me

[DippyDame in reply to Jacarilla]

I think those of us who rely on T3 to function do so in spite of (most) medical advice ...not because of it.

i doubt I'd be here now, ranting on the subject, if I had listened to the endo who proved himself clueless!!

Instead, we have learned from the real experts...those with enquiring and open minds who have lived experience of using T3

You can do this!

Be patient and determined and you will come to understand T3 and how to use it....it saved my life!

[joey82]

I think you need to pick up a book and start doing some research into the administration of t3. There is only so much people can advise you on a forum. Good luck.

[DippyDame in reply to joey82]

It depends on the book....and on the forum!

Not all are equal.

[Jacarilla in reply to DippyDame]

This forum has been great, any book recommendations? 😊

[DippyDame in reply to Jacarilla]

thyroiduk.org/further-readi...

Maybe to start, read the following authors...

Dr D- Peatfield

Dr Skinner

Paul Robinson

Vital you optimise vit D, vit B12, folate and ferritin to support thyroid function / conversion.

For good health almost every cell in the body needs to be flooded by T3 in an adequate and constant supply

Your FT3 was miserably low in June, the much higher FT4 indicates poor T4 to T3

Low cellular T3 = poor health

We're all here to help....just ask!

Good luck!

[Jacarilla in reply to DippyDame]

Thanks so much!!

[mfinn in reply to Jacarilla]

Jacarilla. After a while people stabilised on T3, even if they take it with T4, can find that their TSH becomes considerably lower. If this happens your endo will try to frighten you and tell you that you're damaging your heart and your bones will crumble. It's not true. It's over range thyroid hormones that damages the body not TSH because it isn't really a hormone. I'm on T3 only so my TSH is suppressed and has been for 17 years but I don't have heart or bone problems.

[Jacarilla]

thank you for the advice